Sample Utilization Review Coordinator Resume

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Utilization Review Coordinator Resume
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Contact Information:
Full name
Present and permanent addresses
Telephone numbers
Email address
Objective:
To obtain a position as a Utilization Review Coordinator with prominent Health sector or service industry in which a high-level of communication skills, organizational abilities and ability to lead a team experience can be utilized.
Education:
- Practical Nursing Program, 1980, Western Oklahoma Area VO Tech Burns Flat, Okla
- Certificate in Medical Secretary, 1976, Oklahoma State Tech Okmulgee, Okla
Experience:
St. Johns/Sapulpa Sapulpa, OK, October 2000 – Present
Director of Utilization Review
- Case Management and Utilization Review to consist of Concurrent Review, Pre-certification, Retrospective Review, Discharge Planning and Social Service to provide assistance to patients and their families.
- Converse with insurance companies to provide clinical review to substantiate admission and concurrent stay.
- Referral Coordinator for Five Family Practice Practitioners. Critical Access Hospital Experience/Knowledge.
- As a Admissions Manager, supervisor of admissions as well as all out-patients procedures to include verification of insurance/benefits management, pre-certification and the day to day operations of the department.
Cemara Health Inc. Tulsa, Okla August 1997 – September 2000
Utilization Review Manager/Case Manager
- Pre-Certification, Concurrent, Retro-respective Review and Case Manager for Self-Insured companies.
- Medical Claim Review and Re-pricing auditing. Workers-Compensation Liaison.
- Department Manager and Office Manager. Billing and clerical support for Case Management.
- Responsible for Pre-certification, Concurrent and Retro-Respective Reviews.
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